Just fill in the form below and leave the rest to us. We'll call and confirm a time.

First Name *

Last Name

Contact Phone Number*

Email *

What is your preferred day to be contacted?* MondayTuesdayWednesdayThursdayFridaySaturday (until 1pm)

What is your preferred time to be contacted? Note that the service finishes at 1pm on Saturdays.*9-1111-11-33-5

*This information will only be used by our staff to establish a suitable time to call you. Understandably, we may call at a time you are unable to freely speak to us. We will ask you if it’s a suitable time and if not, we will rearrange the call for another time. We’re here to help when you are ready.

Choose three preferred times that suit you to meet with one of our counsellors. Don’t worry if you don’t know just yet, we will call you to confirm these times or make other arrangements.

Choice 1

Time:
Date:

Choice 2

Time:
Date:

Choice 3:

Time:
Date:

Take the self assessment quiz

Is gambling becoming a problem for you?

if you are worried about your gambling you can use
this quiz to find out if it is becoming a problem.

Scoring

For each question there are four possible responses:

Never (score 0)Sometimes (score 1)Most of the time (score 2)Almost always (score 3)

Think about the last 12 months

0

1

2

3

Have you bet more than you could really afford to lose?*

Have you needed to gamble with larger amounts of money to get the same feeling of excitement?*

Have you gone back on another day to try to win back money you have lost?*

Have you borrowed money or sold anything to gamble?*

Have you felt you might have a problem with gambling?*

Have people criticised your betting or told you that you had a gambling problem, whether or not you thought it was true?*

Have you felt guilty about the way you gamble or what happens when you gamble?*

Has your gambling caused you any health problems, including stress or anxiety?*

Has your gambling caused any financial problems for you or your household?*

Total

Take the self assessment quiz - part2

What does your score mean?

0

You experience no issues with gambling. However, keep an eye on your gambling so it does not become a problem in the future.

1-2

A low-risk gambler
- You experience few, if any issues with gambling. However, keep an eye on your gambling so it does not become a problem in the future.

3-7

A moderate-risk gambler
- You experience few, if any issues with gambling. Now is the time to take a practical step to ensure your gambling remains under control. Contact Gambler's Help Southern

8+

A high-risk gambler
- There are many way to get help. For immediate help call 9575 5353 or after hours on 1800 858 858 or visit gamblinghelponline.org.au. It's free, confidential and available 24 hours a day, seven days a week.

This Quiz is based on the problem Gambling Severity Index, part of the Canadian Problem Gambling Index and is a reliable measure of problem gambling.

Help is closer than you think

Meeting with a qualified, professional counsellor face to face is just a phone call away. We have many locations across South Eastern Melbourne and Peninsula regions, offering help for individuals, couples, families and groups.

Help is closer than you think

Meeting with a qualified, professional counsellor face to face is just a phone call away. We have many locations across South Eastern Melbourne and Peninsula regions, offering help for individuals, couples, families and groups.